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Role Description

Athens Administrators has an immediate need for a full-time Bilingual Senior Claims Examiner to support our workers compensation offices and can be located anywhere in Southern California. Employees who live less than 26 miles from the Orange, CA offices are required to work once a week in the office on a day determined by their supervisor between Tuesday – Thursday. The remaining days can be worked remotely if technical requirements are met, and the employee resides in Southern California. The schedule for this position is Monday-Friday at 37.5 hours a week with the option of a flex schedule.

• Adjust workers’ compensation claims from inception through settlement and closure
• Ensure timely processing of claims and payment of benefits
• Manage and direct medical treatment
• Set reserves and negotiate settlements
• Use fluent Spanish skills with claimants on the account

Qualifications

• Fluency in Spanish required
• High School Diploma or equivalent (GED) required for all positions
• AA/AS or BA/BS preferred but not required
• Administrators Certificate from Self-Insurance Plans will be required within one year of employment if not already obtained
• Must possess a current Experienced Indemnity Claims Adjuster Designation, provided by an insurer, as defined in California Code of Regulations, Title 10, Chapter 5, Subchapter 3, Section 2592.01(f)
• 3+ years recent workers compensation claims handling experience required
• At least 5 years of workers compensation claims experience preferred
• Solid knowledge of workers compensation laws, policies and procedures
• Completion of IEA or equivalent courses
• Proficiency in determining case value and negotiating settlements
• Understanding of medical and legal terminology
• Mathematical calculating skills
• Well-developed verbal and written communication skills with strong attention to detail
• Excellent organizational skills and ability to multi-task
• Ability to type quickly, accurately and for prolonged periods
• Proficient in Microsoft Office Suite
• Ability to learn additional computer programs
• Reasoning ability, including problem-solving and analytical skills
• Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization
• Seeks to include innovative strategies and methods to provide a high level of commitment to service and results
• Ability to demonstrate care and concern for fellow team members and clients in a professional and friendly manner
• Acts with integrity in difficult or challenging situations

Requirements

• Athens’ operations involve handling confidential, proprietary, and highly sensitive information
• Must be able to reliably commute to meetings and events as required by this position

Benefits

• Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options
• 401k (and Roth)
• Company-Paid STD & LTD
• Eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments

Company Description

We have been dynamic, innovative leaders in claims administration since our founding in 1976. We foster an environment where employees not only thrive but consistently recognize Athens as a “Best Place to Work.” Immerse yourself in our engaging, supportive, and inclusive culture, offering opportunities for continuous professional growth.